Metro Health is examining the possibility of a deeper foray into cardiac care, including open-heart surgery.

A year and a half after moving to a new suburban hospital campus in southwest Kent County, the health system wants to know whether there is enough market demand for another cardiac surgical program in West Michigan.

President and CEO Mike Faas says there is anecdotal evidence for doing it through physicians and surgeons who have voiced the need for more capacity locally for cardiac surgery.

A consultant's review due for completion this spring will provide the data for Metro to make a strategic decision on whether to pursue an open-heart program.

"We don't know in our heart that we want to do heart surgery," Faas said. "Our question is -- Do we really want to ask the question? Do we really want to do open-heart surgery? Is that the right thing to do?

"We believe there is an access problem. But we need to prove it."
If Metro decides to proceed, Faas believes it could meet state certificate-of-need standards to launch a cardiac surgical program.

Metro would seek a partner to expand cardiac care and perform heart surgery, much like it did last year in collaborating with the University of Michigan Health System to launch radiation therapy at the Cancer Center at Metro Health Village.

Metro, which three years ago secured a CON to perform emergency heart angioplasty, has approached U of M about a similar venture to expand cardiac care and heart surgery, Faas said. The Ann Arbor health system's response has been "very lukewarm," Faas said, much like it was when the idea of a cancer venture was first introduced.

Cardiac surgery is presently performed in West Michigan at Spectrum Health in Grand Rapids, as well as Mercy Health Partners in neighboring Muskegon County and Borgess Health and Bronson Healthcare Group in Kalamazoo.

Part of the equation in determining whether to pursue a program at Metro is going through CON approval, a process that's likely to generate opposition from competitors.

Metro, because of its relationship with U of M, is no longer part of a purchasing network consisting of several hospitals and administered by Spectrum Health, and Faas worries -- as do other health care executives in the market -- about how Spectrum's formation of a physician group will affect patient referrals.

"Is it worth the battle? Is there a reason to really do this? If not, we won't," Faas said, recalling the contentious process earlier this decade to change CON standards that allowed Metro to relocate 10 miles from its former campus on the southeast side of Grand Rapids.

Lody Zwarensteyn, president of the Alliance for Health in Grand Rapids, said an examination of cardiac services and capacity in the region is probably needed, though he can't say if another open-heart program is justified.

As always when the expansion of big-ticket clinical services is discussed,
Zwarensteyn advocates a community-based planning approach.

"At some point in time in the near future, we should be looking at the distribution of cardiac services. I think it would be appropriate for this community," Zwarensteyn said. "The community has to assess the need for additional resources and then the distribution of those if there is a need for more capacity."

"We've always said any other hospital needs to do what it needs to do for its patients.
We do what we do for our patients," Spectrum's Paula McKenzie said.

Spectrum performed 982 open-heart surgeries in the 2008 fiscal year that ended June 30 and has been trending "slightly downward" in volumes in the last few years from more than 1,000, McKenzie said.

Angioplasty procedures with balloons and stents totaled more than 2,800 in FY 2008, a volume level that has remained steady in recent years, she said.

Metro is weighing the expansion of cardiac care as it explores other potential partnerships with the U of M Health System, including medical education and upgrading its emergency department to level 2 trauma status, Faas said.

Metro prefers to forge partnerships locally, with Spectrum Heath and Saint Mary's Health Care, for growing clinical services at its Metro Health Village. If not, he said, the health system will seek other partners from outside of the market.